Preventing and treating pressure ulcers and related injuries have long been keys to success in the post-acute care world. Thanks to federal regulation changes that kicked in at the start of 2019, they’re about to become even more important as well, especially for home health providers.
The Improving Medicare Post-Acute Care Transformation Act of 2014 — signed into law under the Obama administration and more commonly referred to as the IMPACT ACT — is a bill meant to improve the quality of post-acute care services and how they’re reported. That specifically includes how post-acute care providers handle pressure ulcers and related injuries, Jennifer Maxwell, co-founder and president of Maxwell Healthcare Associates said during a recent webinar.
“[Regulators] are really trying to increase positive outcomes across the board for different post-acute care settings,” Maxwell said. “Being able to carry data forward in a unified way so that providers in each of the post-acute care settings have consistent information is meant to help patients.”
Maxwell Healthcare Associates is a Minnesota-based home health and hospice consulting firm that specializes in technology, compliance, due diligence, regulatory services and financial performance.
When it comes to managing pressure ulcers and related injuries, the IMPACT Act has already meant big changes for long-term care hospitals (LTCHs), skilled nursing facilities (SNFs) and in-patient rehabilitation facilities (IRFs). Home health agencies have newfound responsibilities for preventing and treating pressure ulcers and related injuries as of Jan. 1, 2019.
Overall, OASIS changes include six new items, seven revised items and 28 removed items. Of the seven revised items, four focus heavily on pressure ulcers and related injuries: M1306, M1311, M1322 and M1324.
M1306 corresponds to unhealed pressure ulcers or injuries at Stage 2 or higher, M1311 corresponds to current number of unhealed pressure ulcers or injuries at each stage, M1322 corresponds to current number of Stage 1 pressure injuries, while M1324 corresponds to stage of most problematic unhealed pressure ulcer or injury that is stageable.
Although there are certain exclusions and other changes to consider, on a high level, the IMPACT Act means home health agencies will have to be more diligent and make sure their caregivers are well-trained in clinical and documentation capabilities. Otherwise, experts say, their quality scores could suffer — or worse.
“As a clinically trained nurse with a wound care background, I know based on education of multiple staffs in multiple states over many years that wound care education in nursing school is not a top priority,” said Amy Cassata, vice president of clinical for Swift Medical, a technology platform that streamlines clinical and administrative wound care management workflows. “It’s covered very briefly.”
Besides quality scores, mishandling pressure ulcers — and skin care at large — could inevitably lead to devastating lawsuits, a trend not infrequently seen in the SNF world.
Among the steps needed to guarantee readiness, home health providers should ensure that agency staff members know how to properly code wounds for OASIS-D accuracy and that all nurses are trained on how to do comprehensive head-to-toe assessments. Additionally, home health agencies should also measure skin integrity at the start of care and regularly, meaning every visit, while ensuring supervisors are notified immediately when patient risk is rising for appropriate response time.
Technology like Swift’s also stands to save time and drive efficiencies in the preparation process. The platform assists with image capture, automatic risk scoring, assessment scheduling and claims submission—all of which are critical in wound care management under the new rule.
You need to be proactive — not reactive — with your wound care and prevention.Amy Cassata, Swift Medical
“You need to be proactive — not reactive — with your wound care and prevention,” Cassata said.
Many home health professionals lack confidence in being able to identify at-risk patients before pressure ulcers and related injuries develop. Similarly, many do not yet have processes and tools in place to effectively manage and heal wounds.
Swift Medical — which works with more than 1,000 health care organizations across the United States — is a leading resource for agencies looking to boost their operations and compliance pertaining to ulcers and skin care. Swift Medical’s wound measurement tools, for example, have been shown to reduce errors in measurement by 44% over the traditional ruler method. Its risk dashboard also gives real-time insights into skin care across an agency’s entire census.
“We can’t prevent every one, but we should try our hardest to put all the prevention in place,” Maxwell said. “At Maxwell Healthcare Associates, we really do feel that technology is the way for agencies to be able to be successful long term in this time of change and increased regulations.”
To learn more about how Swift Skin & Wound can help your organization meet the new OASIS requirements for pressure ulcer management, watch the full webcast here.